According to an article in the Pittsburgh Post-Gazette, physicians in Pennsylvania are lobbying the legislature to renew a program in which the revenues from a 25 cent increase in the state's cigarette tax is allocated to help subsidize doctors' required malpractice premium payments. The program is apparently out of money and will die if the legislature does not renew the cigarette tax increase for this purpose.
At the same time, the Governor and Democratic legislative leaders are attempting to tie the malpractice premium rebate proposal to a proposal to expand health coverage for uninsured Pennsylvanians -- a program which would be funded by...
... you guessed it: a 10 cent per pack increase in the state cigarette tax.
State Republican leaders appear reluctant to approve the cigarette tax increase to expand health care, but the Democrats seem to be using the renewal of the malpractice premium abatement program as a bargaining chip to induce the GOP to agree to the health care expansion -- and an additional increase in the cigarette tax.
According to the article: "A rebate program that helps Pennsylvania doctors pay for costly malpractice insurance appears to be on life support, but doctors are scheduled to rally in Harrisburg's Capitol rotunda today in hopes that the state Legislature and the governor's office don't pull the plug. For years, Pennsylvania doctors have relied on abatements to help them obtain medical malpractice insurance coverage through the state's Medical Care Availability and Reduction of Error fund. State law requires doctors to obtain $500,000 of med-mal coverage through the open market and another $500,000 through the Mcare insurance fund, which charges doctors a fee, then pays malpractice claims out of the fund. The abatement subsidies cut the cost of the Mcare coverage in half for most doctors, while high-risk doctors -- OB-GYNs, brain surgeons and so on -- are eligible for a full abatement in their Mcare assessments, meaning the extra $500,000 in coverage costs them nothing."
"But the fund abatements haven't been renewed. Gov. Ed Rendell and House Democrats say they won't move on the Mcare abatement program unless the state Senate, controlled by the GOP, first agrees to a plan to extend health-care coverage to greater numbers of Pennsylvanians, a central theme in the governor's budget proposal from this year. Senate Republicans, meanwhile, say they won't reauthorize the Pennsylvania Health Care Cost Containment Council without resolution of the Mcare abatement issue. The original authorization is set to expire this November."
"But the governor's office says the state has a moral obligation to take care of uninsured Pennsylvanians, as well as the doctors who care for them. 'We certainly believe that the Mcare extension should be done, but also believe that uninsured Pennsylvanians deserve as much consideration from the commonwealth as do doctors,' said Chuck Ardo, the governor's spokesman. 'If we can add a 25-cent levy on cigarettes to benefit doctors, we can certainly add an additional dime, and tax cigars and smokeless tobacco, to benefit the uninsured.'"
The Rest of the Story
This is about as absurd of a story as I think I've ever reported here. You mean to tell me that Pennsylvania is helping to pad the pockets of doctors - reducing their insurance premium payments - by relying on the consumption of cigarettes by those physicians' patients?
Don't get me wrong. I can't see the use of government resources - that is, my taxes - to help cushion the lifestyle of physicians by subsidizing the insurance premiums that the rest of us have to pay ourselves out of our own pockets. No one is subsidizing my insurance premiums. Why should the states' taxpayers be subsidizing the insurance payments for Pennsylvania doctors?
But what makes the story crazy and not just unjust is that the money to subsidize physicians' insurance payments is coming out of the pockets of their smoking patients.
What a perverse incentive this creates for Pennsylvania physicians. They need smokers to continue buying cigarettes in order for their insurance rebates to continue. Thus, there is a strong economic incentive for these physicians to do what they can to ensure that their patients do not quit smoking.
I have decided to go into the T-shirt business and start selling in Pennsylvania tomorrow. Here is a sampling of the slogans on the T-shirts I will be marketing to Keystone State smokers:
"I support my doctor. I smoke."
"A cigarette a day helps the physician not pay."
"I'm doing something about the rising costs of malpractice insurance. I'm smoking."
"I care about the profits of the medical profession: I smoke."
"Marlboro: Welfare for Doctors"
"Don't let your doctor down. Chain smoke."
"Help preserve physician wealth: Light one up."
"Keep our doctors in PA: Buy cigarettes."
"Don't bite the hand that heals you: smoke."
"Do just what the doctor ordered: Smoke a fag."
"The Pennsylvania Medical Association wants you to exercise regularly and eat a healthy diet. But whatever you do, don't stop smoking."
"Take a hit from your cigarette, not from your doctor's insurance."
"Don't let your doctor be taken to the cleaners: Keep smoking."
"Pennsylvania doctors recommend Camel, or any cigarette. The more expensive, the better."
"Help physicians to save lives: smoke whenever you can."